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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 361 records · Page 20Linked to original sources
PubMed2003

Mediated consumer-provider communication in cancer care: the empowering potential of new technologies.

New communication technologies represent a potentially valuable resource for cancer care and education. With the Internet and multimedia programs (e.g. CD-ROMs), health care consumers have access to a wealth of information about cancer and its treatment, can participate in online support groups, and can interact with medical experts across the globe. To be most effective, these interventions must be designed, developed, implemented, and evaluated using a sound conceptual framework that connects factors affecting utilization, the user's experience within the media environment, and post interaction outcomes. This essay presents two health communication frameworks, an expanded model of health care consumer-provider communication and a three-stage model of health promotion using interactive media, to help guide future research and development of innovative technologies for cancer care and education.

Communication↗
PubMed2002

Supplementation with antioxidant vitamins prevents oxidative modification of DNA in lymphocytes of HIV-infected patients.

There is evidence suggesting that patients infected with human immunodeficiency virus (HIV) are under chronic oxidative stress. In the present study, the level of oxidatively modified bases in lymphocyte DNA and some other parameters of oxidative stress were measured in HIV-infected patients (n = 30), as well as in control groups (10 healthy volunteers and 15 HIV-seronegative injected drug users). Additional experiments were conducted using lymphocyte DNA samples from asymptomatic seropositive, HIV-infected patients who were supplemented with antioxidant vitamins A, C, and E or received placebo. Significant increases in the amount of the modified DNA bases were observed in HIV-infected patients when compared with the control group. The concentration of thiobarbituric acid reactive substances (TBARS) was higher and activities of antioxidant enzymes (superoxide dismutase and catalase) were lower in the group of HIV-infected patients in comparison to the control group. Vitamin supplementation resulted in the significant decrease in the levels of all modified DNA bases when compared to the patients who received placebo. The reduction of TBARS and the restoration of the activity of the enzymes were also observed. Our data suggest that people infected with HIV can benefit from treatment with antioxidant vitamins.

Adolescent↗
PubMedDate not supplied

Survey of tourniquet use in podiatric surgery.

Tourniquet use in foot and ankle surgery is common practice; however, the technique varies among foot and ankle surgeons and there are no standard guidelines. To analyze trends in foot and ankle tourniquet use, the authors conducted an e-mail survey. One thousand six hundred sixty-five foot and ankle surgeons were sent a tourniquet-use survey via e-mail, across Canada and the United States. Nineteen percent of the recipients completed and returned the surveys. Eleven (3.4%) rarely or never use a tourniquet and 8 (2.5%) use an Esmarch bandage tourniquet at the ankle. Most use pneumatic ankle cuffs (92% use, 27% use exclusively); many also use thigh cuffs (69%) and some also use calf cuffs (15%). Most thigh-cuff users (62%) experience problems with cuff fit sometimes or often. All but 3 respondents exsanguinate the limb before tourniquet inflation. Specific devices used for exsanguination varied among surgeons. Most commonly used tourniquet pressures range from </=200 to 350 mm Hg at the ankle and </=200 to >/=351 mm Hg for the thigh (64% use pressures between 301 and 350 mm Hg). Only 7% of respondents consider limb occlusion pressure when selecting tourniquet cuff pressure. Based on published studies of limb occlusion pressures, these ranges suggest that some of the more common pressure settings may be higher than necessary for many patients. Vascular disease or previous bypass (91%) and deep vein thrombosis (83%) were the most commonly listed contraindications to tourniquet use. Approximately 10% of respondents have either experienced or learned of skin and nerve injuries secondary to lower extremity tourniquet use at any level. The varied responses show a lack of overall consensus on tourniquet pressure settings. Guidelines for optimizing cuff pressure and technique should be established to minimize the risk of complications.

Ankle↗
PubMed1996

Virtual Reality Hysteroscopy

New interactive computer technologies are having a significant influence on medical education, training, and practice. The newest innovation in computer technology, virtual reality, allows an individual to be immersed in a dynamic computer-generated, three-dimensional environment and can provide realistic simulations of surgical procedures. A new virtual reality hysteroscope passes through a sensing device that synchronizes movements with a three-dimensional model of a uterus. Force feedback is incorporated into this model, so the user actually experiences the collision of an instrument against the uterine wall or the sensation of the resistance or drag of a resectoscope as it cuts through a myoma in a virtual environment. A variety of intrauterine pathologies and procedures are simulated, including hyperplasia, cancer, resection of a uterine septum, polyp, or myoma, and endometrial ablation. This technology will be incorporated into comprehensive training programs that will objectively assess hand-eye coordination and procedural skills. It is possible that by incorporating virtual reality into hysteroscopic training programs, a decrease in the learning curve and the number of complications presently associated with the procedures may be realized. Prospective studies are required to assess these potential benefits.

Journal Article↗
PubMed1996

Students' learning of clinical sonography: use of computer-assisted instruction and practical class.

RATIONALE AND OBJECTIVES: The application of information technology to teaching radiology will profoundly change the way learning is mediated to students. In this project, the integration of veterinary medical students' knowledge of sonography was promoted by a computer-assisted instruction program and a subsequent practical class. METHODS: The computer-assisted instruction program emphasized the physical principles of clinical sonography and contained simulations and user-active experiments. In the practical class, the students used an actual sonographic machine for the first time and made images of a tissue-equivalent phantom. Students' responses to questionnaires were analyzed. RESULTS: On completing the overall project, 96% of the students said that they now understood sonographic concepts very or reasonably well, and 98% had become very or moderately interested in clinical sonography. CONCLUSIONS: The teaching and learning initiatives enhanced an integrated approach to learning, stimulated student interest and curiosity, improved understanding of sonographic principles, and contributed to an increased confidence and skill in using sonographic equipment.

Attitude↗
PubMed1990

Diathermy haemostasis at tonsillectomy: current practice--a survey of U.K. otolaryngologists.

The use of diathermy in achieving haemostasis at tonsillectomy was assessed by means of a postal questionnaire sent to consultant otolaryngologists practising in the U.K. A response of 81 per cent was obtained. Forty-four per cent presently use diathermy. Few considered the age of the patient or a history of a quinsy a contraindication to its use. The diathermy experience of users and non-users with regard to speed, post-operative pain and haemorrhage differs markedly. This dichotomy of opinions is confirmed by a review of the literature. Clearly there is a need for further studies to clarify the role of diathermy in tonsillectomy.

Adult↗
PubMed2001

COX-2 inhibition and prevention of cancer.

The potential for cyclo-oxygenase inhibition in cancer prevention and treatment is founded on epidemiology (reduction of colorectal cancer in aspirin users), animal experiments and molecular genetics. Trials using the NSAID sulindac also reduced the number of polyps in patients with familial adenomatous polyposis, but the well-known gastrointestinal toxic effects of aspirin and NSAIDs have discouraged the exploitation of their antineoplastic potential. The advent of specific COX-2 inhibitors, which do not interfere with the cytoprotective constitutive COX-1 enzyme, and the demonstration of increased COX-2 expression in many common malignancies beside colorectal cancer, has opened up new therapeutic possibilities. Recently a non-cyclo-oxygenase effect of COX-2 inhibitors, which combines the PPARdelta and the APC tumour suppressor activity, was also demonstrated. The selective COX-2 inhibitor celecoxib has been approved by the FDA for adjuvant treatment of familial adenomatous polyposis, and a large number of prevention and treatment trials of colorectal and other common cancers (prostate and breast cancer) have been started.

Breast Neoplasms↗
PubMed1982

[Training and quality assurance in ultrasound diagnosis].

Medical ultrasound equipment is mainly used for diagnostic purposes. Examiner, patient, measuring equipment and ultrasound-based diagnosis form the ultrasound diagnostic system which is characterised by a multitude of internal and external relations. By extending the scope of the system, quality assurance of the ultrasound diagnostic procedures is improved with regard to the physical performance of the system. The performance standards should be established internationally. Even the best of equipment is only as good as the user's experience In this respect, the standards have to be met theoretically and practically on all levels of medical education. The most appropriate settings would be represented by national associations of ultrasound. The introduction of ultrasound diagnostic procedures on the level GP everyday work should lead to a decrease in cost and an increase in speed and efficiency by eliminating routine x-ray examinations.

Curriculum↗
PubMed1992

Emergency management of cocaine intoxication. Counteracting the effects of today's 'favorite drug'.

The toxic effects of cocaine are becoming more widely recognized as the popularity of the drug increases. Although overdose is usually fatal, treatment is available for users who experience agitation, seizure, arrhythmias, severe hypertension, or other side effects. Hospital admission is often necessary to allow monitoring of the acute situation. Initial management involves standard life-support measures. Therapeutic agents are given, as appropriate, both to control acute reactions and to counteract continuing toxicity.

Cocaine↗
PubMed1998

Clinical trial of a digital hearing aid.

A clinical trial of Oticon DigiFocus hearing aid was performed. The test aid was evaluated on 33 subjects with several years' experience as users of modern analog hearing aids. These aids were used as reference for the 1-month-long trial. The Abbreviated Profile of Hearing Aid Benefit (APHAB) showed a mean difference in benefit with superior ratings for the test aid concerning ease of communication, speech in reverberation and speech in background noise. The subjects' own aids were rated somewhat better concerning aversiveness of sounds, but this difference was not statistically significant. The Gothenburg Profile showed a statistically significant difference between the test aid and the reference aids in favour of the test aid. The difference was not most evident with regard to speech communication and the effects of hearing loss on social interactions. Sound quality ratings concerning clearness were significantly higher for the test aid. Speech recognition thresholds in noise were on average 0.7 dB better for the test aids when tested at speech levels 60 and 75 dB. The difference was statistically significant only at 75 dB. There was significant interaction between general preference and hearing aid type, indicating that overall sound quality was an important factor affecting the general preference for either the test aid or the reference aid. Twenty-three subjects generally preferred the test aid, six preferred their own aid and four stated no difference.

Adult↗
PubMed2006

The effects of prosthetic foot roll-over shape arc length on the gait of trans-tibial prosthesis users.

The Shape&Roll prosthetic foot was used to examine the effect of roll-over shape arc length on the gait of 14 unilateral trans-tibial prosthesis users. Simple modifications to the prosthetic foot were used to alter the effective forefoot rocker length, leaving factors such as alignment, limb length, and heel and mid-foot characteristics unchanged. Shortening the roll-over shape arc length caused a significant reduction in the maximum external dorsiflexion moment on the prosthetic side at all walking speeds (p < 0.001 for main effect of arc length), due to a reduction in forefoot leverage (moment arm) about the ankle. Roll-over shape arc length significantly affected the initial loading on the sound limb at normal and fast speeds (p = 0.001 for the main effect of arc length), with participants experiencing larger first peaks of vertical ground reaction forces on their sound limbs when using the foot with the shortest effective forefoot rocker arc length. Additionally, the difference between step lengths on the sound and prosthetic limbs was larger with the shortest arc length condition, although this difference was not statistically significant (p = 0.06 for main effect). It appears that prosthesis users may experience a drop-off effect at the end of single limb stance on prosthetic feet with short roll-over shape arc lengths, leading to increased loading and/or a shortened step on the contralateral limb.

Adult↗
PubMedDate not supplied

Implications of chronic methamphetamine use: a literature review.

Methamphetamine (MA) abuse is increasing to epidemic proportions, both nationally and globally. Chronic MA use has been linked to significant impairments in different arenas of neuropsychological function. To better understand this issue, a computerized literature search (PubMed, 1964-2004) was used to collect research studies examining the neurobiological and neuropsychiatric consequences of chronic MA use. Availability of MA has markedly increased in the United States due to recent technological improvements in both mass production and clandestine synthesis, leading to significant public health, legal, and environmental problems. MA intoxication has been associated with significant psychiatric and medical comorbidity. Research in animal models and human subjects reveals complicated mechanisms of neurotoxicity by which chronic MA use affects catecholamine neurotransmission. This pathology may underlie the characteristic cognitive deficits that plague chronic MA users, who experience impairments in memory and learning, psychomotor speed, and information processing. These impairments have the potential to compromise, in turn, the ability of MA abusers to engage in, and benefit from, psychosocially based chemical-dependency treatment. Development of pharmacological interventions to improve these cognitive impairments in this population may significantly improve the degree to which they may be able to participate in treatment. Atypical antipsychotics may have some promise in this regard.

Chronic Disease↗
PubMed2004

The effect of preapplication of corticosteroids on skin irritation and performance of the GlucoWatch G2 Biographer.

Skin irritation due to iontophoresis may limit the frequency of use of devices for drug delivery or transdermal extraction of analytes of clinical interest. This study examined whether preapplication of corticosteroid preparations could reduce skin irritation from iontophoresis used by the GlucoWatch G2 Biographer (Cygnus, Inc., Redwood City, CA) in monitoring interstitial glucose levels frequently and automatically. Numerous corticosteroid preparations were screened to identify formulations that did not interfere with adhesion of the Biographer to the skin or glucose sensing. Kenalog (Westwood-Squibb Pharmaceuticals, Inc., Buffalo, NY) (triamcinolone acetonide) and Cortizone-10 Quick Shot (Pfizer, Inc., New York, NY) (hydrocortisone) sprays were selected and, in a double-masked, randomized, controlled trial, were applied to the forearms of 66 subjects with diabetes and allowed to dry. Biographers were applied and worn for 15 h, and home blood glucose measurements were taken every 30 min to assess accuracy. Irritation was assessed periodically by trained observers and study subjects. Skin irritation was reduced by both corticosteroid sprays, with the fraction of subjects who experienced moderate irritation reduced by 57% and 43% for the Kenalog and Cortizone-10 Quick Shot sprays, respectively. The treatment effect persisted at the 1-week assessment. Preapplication of these preparations did not affect the clinical utility of interstitial glucose readings. Preapplication of Kenalog or Cortizone-10 Quick Shot sprays significantly reduced skin irritation due to iontophoresis, and did not interfere with glucose measurements. This approach may enable the minority of users who experience moderate to severe skin irritation to use the Biographer more frequently for diabetes management.

Adrenal Cortex Hormones↗
PubMed2002

Hybrid alignment: high-performance with universal statistics.

The score statistics of a recently introduced 'hybrid alignment' algorithm is studied in detail numerically. An extensive survey across the 2216 models of protein domains contained in the Pfam v5.4 database (Bateman et al., Nucleic Acids Res., 28, 263-266, 2000) verifies the theoretical predictions: For the position-specific scoring functions used in the Pfam models, the score statistics of hybrid alignment obey the Gumbel distribution, with the key Gumbel parameter lambda taking on the asymptotic value 1 universally for all models. Thus, the use of hybrid alignment eliminates the time-consuming computer simulations normally needed to assign p-values to alignment scores, freeing the users to experiment with different scoring parameters and functions. The performance of the hybrid algorithm in detecting sequence homology is also studied. For protein sequences from the SCOP database (Murzin et al., J. Mol. Biol., 247, 536-540, 1995) using uniform scoring functions, the performance is found to be comparable to the best of the existing methods. Preliminary results using the PfamA database suggest that the hybrid algorithm achieves similar performance as existing methods for position-specific scoring systems as well. Hybrid alignment is thereby established as a high performance alignment algorithm with well-characterized, universal statistics.

Algorithms↗
PubMed2006

Hierarchical and multi-resolution representation of protein flexibility.

MOTIVATION: Conformational rearrangements during molecular interactions are observed in a wide range of biological systems. However, computational methods that aim at simulating and predicting molecular interactions are still largely ignoring the flexible nature of biological macromolecules as the number of degrees of freedom is computationally intractable when using brute force representations. RESULTS: In this article, we present a computational data structure called the Flexibility Tree (FT) that enables a multi-resolution and hierarchical encoding of molecular flexibility. This tree-like data structure allows the encoding of relatively small, yet complex sub-spaces of a protein's conformational space. These conformational sub-spaces are parameterized by a small number of variables and can be searched efficiently using standard global search techniques. The FT structure makes it straightforward to combine and nest a wide variety of motion types such as hinge, shear, twist, screw, rotameric side chains, normal modes and essential dynamics. Moreover, the ability to assign shapes to the nodes in a FT allows the interactive manipulation of flexible protein shapes and the interactive visualization of the impact of conformational changes on the protein's overall shape. We describe the design of the FT and illustrate the construction of such trees to hierarchically combine motion information obtained from a variety of sources ranging from experiment to user intuition, and describing conformational changes at different biological scales. We show that the combination of various types of motion helps refine the encoded conformational sub-spaces to include experimentally determined structures, and we demonstrate searching these sub-spaces for specific conformations.

Algorithms↗
PubMed1998

Needs assessment in mental health services: the DISC framework.

People with mental health problems have a range of health and social care needs that result in both illness and disability (effects of the illness on social functioning and citizenship). If service development is to be creative and innovative, needs assessment has to focus on the identification of actual need--rather than using the existing services as the basis of planning. To be valid, needs assessment must use the experience of users and their families, yet it can be highly frustrating for all concerned if there is not a clear framework to structure the wide-ranging information that will be collected through this sort of exercise. This paper proposes a framework for structuring needs assessment and discusses how it can be used for local mental health service development through a 'stakeholder' approach. The framework can be used to identify a comprehensive set of service functions, that is, what a service actually needs to be doing if the range of peoples' needs are to be met. The use of the framework to structure activity at different levels in the service system is discussed.

Community Mental Health Services↗
PubMed2004

Active personal dosemeters for individual monitoring and other new developments.

In this paper, we will present a first (but not complete) status description of active personal dosemeters (APDs) and their implementation in European countries. In modern radiation protection practices, APDs are becoming absolutely necessary operational tools for satisfying the ALARA principle. Despite their success, they are relatively new for individual monitoring of workers. Regulation, legal requirements and calibration procedures are different in European member states. A catalogue of commercially available and prototype devices is presented. Improvement on devices and in implementation of calibration method are expected in the forthcoming years. End-user feedback experience and requirements are reported.

Body Burden↗